E-cigarettes contribute to increased tobacco use by teens

(Reuters Health) – With the rapidly increasing use of the e-cigarettes by adolescents, overall tobacco use has also increased, a study shows.

An e-cigarette sits in a tray on the bar at the Henley Vaporium in New York City December 18, 2013. REUTERS/Mike Segar

The researchers wondered whether e-cigarettes are recruiting youth who otherwise would never have smoked. The answer seems to be yes, said Dr. Jessica L. Barrington-Trimis from University of Southern California, Los Angeles.

“E-cigarettes are recruiting at least some youth who likely would never have smoked combustible cigarettes,” she told Reuters Health by email.

Her team looked at current cigarette use by 11th and 12th graders in southern California between 1995 and 2014.

The percentage of 12th-graders who said they were currently smoking fell from 19.1 percent in 1995 to 14.7 percent in 2001 and to 7.8 percent by 2014. But the combined use of cigarettes and e-cigarettes added up to 13.7 percent in 2014, which was similar to the number of current smokers in 2001.

Nearly a third of 12th graders admitted in 2014 that they had used cigarettes or e-cigarettes at least once. This was much higher than the 20.4 percent in 2004 and slightly higher than the 30.2 percent in 2001.

The patterns were similar for 11th graders and for males and females, the researchers noted in Pediatrics.

Current smoking rates were consistently higher among white adolescents than among Hispanic adolescents, although similar numbers admitted to having ever tried cigarettes or e-cigarettes.

“The high combined prevalence of e-cigarette use or cigarette use in 2014, compared with historical Southern California smoking prevalence, suggests that adolescents are not merely substituting e-cigarettes for cigarettes but that e-cigarettes are instead recruiting a new group of users who would not likely have initiated combustible tobacco product use in the absence of e-cigarettes, which poses a potential threat to the public health of adolescent populations,” the researchers say.

With new regulations “beginning to take hold across the nation raising the age of tobacco purchase (including e-cigarettes) to 21, we might see some changes to adolescent use of e-cigarettes and other tobacco products,” Barrington-Trimis said.

In a related commentary, Dr. Jonathan P. Winickoff from Massachusetts General Hospital in Boston and Sarah E. Winickoff from Brookline Public School, Brookline, Massachusetts suggested several ways to address rising e-cigarette use by adolescents.

“We tried to focus on several practical solutions that can be implemented right now,” Winickoff told Reuters Health. “Educational approaches should be implemented in schools and clinical settings to counter tobacco industry advertising messages.”

“Parents should have conversations with their kids about the dangers of e-cigarettes and express their strong disapproval of these devices and the harmful aerosols they contain,” Winickoff concluded. “Tests show that even when the e-cigarette device is labeled no nicotine or zero nicotine, nicotine is often present.”

“These devices are becoming better at delivering fine particles and nicotine into the blood stream,” he added. “The tobacco industry is working on making the e-cigarette as addictive as possible so that more new users will graduate to lifelong tobacco product addicts. As a pediatrician, I am extremely worried about the next generation becoming addicted to tobacco products.”

Dr. Adam M. Lippert from University of Colorado’s sociology department in Denver told Reuters Health by email that based on this and other studies, “adolescent e-cigarette use increases the likelihood of future conventional cigarette use—a troubling finding that threatens to unravel the gains made over the past two decades against teenage smoking.”

Efforts to teach teens about the risks associated with e-cigarettes may help, he said.